Provider Demographics
NPI:1437172632
Name:ZURBUCH, CASSANDRA ROBIN (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:ROBIN
Last Name:ZURBUCH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:CASSANDRA
Other - Middle Name:ROBIN
Other - Last Name:GANNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:7817 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702
Mailing Address - Country:US
Mailing Address - Phone:301-473-4065
Mailing Address - Fax:301-473-4085
Practice Address - Street 1:7817 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:SUITE A
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702
Practice Address - Country:US
Practice Address - Phone:301-473-4065
Practice Address - Fax:301-473-4085
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18881225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD002914900Medicaid
MD395SMedicare ID - Type Unspecified
MD002914900Medicaid